Assessment and Grading of Acute GVHD

Transcript:

Bonnie J. Dirr, APRN: In terms of grading acute graft-vs-host disease [GVHD], can you please talk to us about assessment in the grading scales? And what scales do you use most often?

Mahasweta Gooptu, MD: I alluded to it a little bit with the last question. For acute GVHD, we use the Glucksberg grading system, which is pretty standard and is used by most centers, by which we see, first, then skin. We look at the body surface area involvement. For diarrhea, we look at the volume of diarrhea, and for the liver we look at the degree of hyperbilirubinemia and, for example, for skin, less than 25% is stage 1, 25% to 50% to stage 2. If you have erythroderma, it’s stage 3, and if in addition you have… then that is stage 4. Then similarly you stage each organ and then you put together the numbers for the staging and give the patient a grade. For that we follow the Glucksberg scale. We follow a different method of grading for chronic GVHD, which I think we’ll come to later in the presentation.

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